Incidental detection of tracheobronchial abnormalities on routine imaging and familiarity with their appear­ances is important to improve diagnosis and patient care. [1] A 65-year-old female patient was admitted with a diagnosis of left fronto-parietal intracerebral hematoma. She was not a known diabetic and hypertensive. Her chest X-ray showed extensive calcification of trachea and main bronchus [Figure 1]. Blood investigations were normal. The patient required tracheostomy and it could be done without complications. Blood investigations including serum calcium were within normal range. She made uneventful recovery. Diffuse tracheobronchial calcifi­cation observed on plain chest radio­graphs is said to be a result of aging. [2] Diffuse tracheobronchial calcifi­cation at radiography most commonly occurs in patients of advanced age [3],[4] and is more frequent in females. [2] In a series of 1152 patients, extensive tracheobronchial calcification was identified in 0.87% of X-rays. [5] Rare causes of focal tracheobronchial cartilage calcification include congenital, [6] following cardiac surgery in children, [7] in patients with hypercalcaemia and hyperphosphataemia, [8] chondrodys­plasia punctata, adrenogenital syndrome, diastrophic dysplasia [9] and in patients with long term warfarin therapy. [10] With the greater use of computed tomography (CT) scan and its more sensitivity to recognize even small amount of calcification is expected to show a higher prevalence of tracheal calcifications. [11] As was seen in the present case and also described in literature that this finding is often striking and visually re­markable; however, but is of no clinical significance. [3],[5]

Figure 1: X-ray appearance of extensive calcifi cation of the trachea and bronchus in an elderly female